The State of the Allied Health Workforce in North Carolina Erin Fraher, MPP Director, NC HPDS Phillip Summers, MPH Research Assistant Katie Gaul, MA Research Associate Stephen Rutledge Research Assistant Presentation to the Council for Allied Health in North Carolina Annual Presidents Meeting May 2, 2007
Today s Presentation: An Overview Why study allied health workforce shortages? Challenges in estimating the supply of, and demand for, allied health professionals The allied health vacancy tracking project Moving forward challenges and opportunities Your questions and input
Why study allied health workforce issues?
Manufacturing and Health Care & Social Assistance Employment, NC, 1995-2005 900 822, 995 Employment (thousands) 800 700 600 500 400 300 332,446 Manufacturing Health Care & Social Assistance 568,835 491,637 200 100 0 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Source: North Carolina Employment Security Commission, 2006. Year
Health Care Jobs in North Carolina, 2005 Other, 3% Physicians, 5% Allied Health Professions, 37% LPNs, 5% RNs, 24% Total Health Care Jobs = 302,270 Note: "Other healthcare occupations" includes: chiropractors, dentists, optometrists, and pharmacists. Source: U.S. Bureau of Labor Statistics, Occupational Employment Statistics (2005). URL: http://www.bls.gov/oes/. Nurse aides, orderlies and attendants, 26%
Healthcare and Allied Health Jobs Grew, Overall Employment Remained Stagnant Total State, Healthcare and Allied Health Employment, North Carolina, 1999-2005 Total N.C. Employment Healthcare Jobs Allied Health Jobs 1999 2005 % Growth (1999-2005) 3,801,670 3,809,690 0.2% 251,550 302,270 20.2% 76,590 111,630 45.8% Source: Bureau of Labor Statistics. Occupational Employment Statistics. State Cross-Industry Estimates: 1999-2005. URL: http://www.bls.gov/oes/. Accessed 06/28/2006.
Hourly and Annual Wages for Selected North Carolina Occupations, 2005 Hourly Mean Annual Mean Occupation Wage Wage Physicians $73.60 $153,072 RNs $24.99 $51,970 LPNs $16.80 $34,940 Allied health professions $18.68 $39,647 All Occupations (North Carolina) $16.57 $34,460 Source: Bureau of Labor Statistics. Occupational Employment Statistics. State Cross-Industry Estimates: 1999-2005. URL: http://www.bls.gov/oes/. Accessed 06/28/2006.
North Carolina s Fastest Growing Occupations % Change in Employment, 2002-2012 Rank Occupation Projected Openings % Change 1 Medical Assistants 4,950 60.9 2 Occup. Ther. Aides 30 60.0 3 Dental Hygienists 2,590 53.9 4 Dental Assistants 3,120 53.0 5 Social and Human Services Assistants 5,110 48.4 6 Med. Record Tech. 2,620 48.3 7 Phys. Ther. Assist. 720 47.7 8 Fitness Trainers 2,780 47.6 9 Resp. Therapy Tech. 330 47.1 10 Respiratory Therapists 1,170 46.8 http://eslmi23.esc.state.nc.us/projections/employmentoutlook.asp?version=aopengp&areatype=01&area=000037&periodid=06
Medical Assistants Employed in North Carolina, 2002-2006 12,000 10,000 9,950 8,000 8,880 # of medical assistants 6,000 6,660 7,260 8,120 Medical assistants are growing at nearly double the projected growth rate 4,000 2,000 0 2002 2003 2004 2005 2006 Source: North Carolina Health Professions Data System with data from the Employment Security Commission. Year
Profile: Medical Assistants Most are employed in physicians offices, perform administrative and clinical tasks Unlicensed and unregulated workers with rapid employment growth Multiple pathways to practice: most are high school graduates with on-the-job training Average hourly wage: $11.89, annual wage $24,740 Employment in both rural and metro areas Often a second career for dislocated workers or individuals who have been out of the labor force Profession seeking increased regulation through uniform educational standards and certification
Enrollment in North Carolina Community College System Medical Assistant Programs, 2006 Number Enrolled, Fall 2005 (# of Counties) 75 to 187 (13) 35 to 74 (12) 1 to 34 (8) None Enrolled (67) Community College with Medical Assisting Program Community College without Medical Assisting Program Sources: NC Community College System and NC AHEC, 2007. Notes: Locations of community colleges and universities are mapped to the ZIP code centroid. Locations and enrollment figures for seven private programs are not included.
Challenges in Estimating the Supply of, and Demand for, Allied Health Professionals
Challenge 1: Defining allied health Open to different interpretations Easier to define what is not allied health: Nurses: LPNs, RNs, NPs Physicians Chiropractors Podiatrists Optometrists Pharmacists Dentists Aides: psychiatric aides, nursing aides, home health aides, orderlies, attendants
Challenge 2: Enumerating the Allied Health Workforce: How Many and Where? Validity, Reliability of Data, a Spectrum Low Medium High Optional professional certification Radiologic Technicians/ Technologists Mix of licensed and certified professionals Speech- Language Pathology Licensed professionals Physical Therapy
Challenge 3: What to do about unlicensed allied health professions? Amount, type and quality of data available from credentialing and certifying organizations varies. Don t know who is in active practice Can t fully enumerate workforce or locate them to counties, employment setting etc.
Result: Lurching from Oversupply to Shortage Allied health professions Ideal intervention point supply time Typical intervention point
Goal: Better Data to Smooth the Allied Health Supply Cycle Ideal intervention point Allied health professions supply time Typical intervention point
Vacancy Reports First report published in May 2005, subsequent report in May 2006. Most recent report is hot off the press.
Vacancy tracking overview Purpose: Estimate workforce demand for selected allied health professions Method: Monitor weekly job listings in newspaper and online sources Data: Latest data collected for twelve professions during 10 week period (September 24-November 26, 2006) Results: Number of vacancies Distribution of vacancies by region and profession Types of employers advertising vacancies
Media Sources Monitored for Allied Health Vacancies Newspapers Asheville Citizen Times Charlotte Observer Fayetteville Observer Greensboro News & Record Hickory Daily Record Raleigh News and Observer Rocky Mount Telegram The Daily Reflector Wilmington Star-News Wilson Daily Times Winston Salem Journal Online Sources Indeed.com Job Search Engine American Society for Radiologic Tech (ASRT) NC Occupational Therapy Association (NCOTA) NC Office of Emergency Medical Services (NCEMS) NC Physical Therapy Association (NCPTA) NC Speech, Hearing & Language Association (NCSHLA) Recreation Therapy Directory
Data collection: Online
Data collection: Newspapers
Professions Included in Latest Report Based on a survey of Council members, twelve professions were selected for monitoring: 1. Medical Technologist 2. Medical Laboratory Technician 3. Occupational Therapist 4. Certified Occupational Therapy Assistant 5. Emergency Medical Technician (Basic, Intermediate, Paramedic) 6. Imaging Professions (PET, MRI, CT) 7. Physical Therapist 8. Physical Therapy Assistant 9. Recreation Therapist 10. Respiratory Therapist 11. Speech Language Pathologist 12. Speech Language Pathology Assistant
Methodological Limitations Advertisements may not reflect true frequency or distribution of vacancies across the state Data need to viewed as a barometer of demand and not a definitive index because the data: Do not capture vacancies advertised through all media such as employer-specific listings Were collected during a single period and may not reflect seasonal variation in workforce demand Data were de-duplicated to try to capture positions versus vacancy advertisements
Vacancies by Profession Physical Therapist 554 Occupational Therapist 275 Physical Therapy Assistant Medical Assistant Speech-Language Pathologist 177 176 172 Occupational Therapy Assistant Respiratory Therapist Medical Technician Medical Technologist 135 127 122 119 Imaging (PET, MRI, CT) Paramedic EMT (Basic or Inter) 61 81 98 Recreation Therapist 23 0 100 200 300 400 500 600
Vacancies by Employment Setting Government 4% Long-Term Care 7% Rehab 8% Other 3% Hospital 29% Home Health 9% Total vacancies = 2,050 Practice 12% Staffing Agency 28% Note: 70 vacancy advertisements were missing setting. Other includes other, laboratories, schools and universities
Vacancy index Need to adjust raw vacancy numbers to account for different workforce size of allied health professions Profession Workforce Size Vacant Vacancy Index Occupational Therapy Assistant 888 135 15.2 Physical Therapist 3,749 554 14.8 Occupational Therapist 1,990 275 13.8 Physical Therapist Assistant 1,859 177 9.5 Speech-Language Pathologist 2,710 172 6.3 Imaging (PET, MRI, CT) 1,853 98 5.3 Recreation Therapist 450 23 5.1 Respiratory Therapist 3,413 127 3.7 Medical Technologist 4,250 119 2.8 Medical Technician 4,950 122 2.5 EMT (Basic, Inter, Paramedic) 6,790 142 2.1 Medical Assistant 9,950 176 1.8 Excludes listings missing employer location (N=22).
Vacancy Advertisements per 10,000 Population by AHEC Region, North Carolina, Fall 2006 Northwest 2.4 Greensboro 2.4 Wake 2.2 Area L 4.4 Mountain 2.3 Charlotte 1.7 NC average was 2.4 vacancies per 10,000 population Southern Regional 2.8 Coastal 3.1 Eastern 2.5 Source: North Carolina Health Professions Data System, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 2006. Notes: North Carolina newspaper and online listings for select allied health professions tracked from September 24 to November 26 (N=2,120). Sample excludes listings missing employer location (N=22).
Summary of Issues: What Do We Know? Allied health employment increasingly important economic sector Allied health employment will increase and the state faces high vacancy rates in some professions Vacancy rates are generally higher in rural, eastern North Carolina Potential investment in educating allied health workers pay large and immediate dividends due to high retention rates Increasing number of allied health workers has potential to increase access to employment and improve access to health care services
Moving Forward: Challenges and Opportunities
Challenges to Moving Forward Existing system is fragmented, limited collaboration exists between policy makers, educators, employers and others charged with monitoring, planning and implementing workforce development strategies at the local and state level. Despite workforce shortages and employer needs for workers, educational system struggles to meet need: Too few qualified applicants Attrition Faculty shortages Lack of clinical placements Cost of allied health education is high
Future Opportunities Better collaboration between health workforce researchers, educators, employers and local workforce development boards Re-envision workforce development efforts to target specific health care professions and/or regions of the state for workforce development Initiative currently underway with leadership out of the Governor s Office/Dept. of Commerce: The allied health sector strategy aims to increase allied health sector competitiveness and employment opportunities
Allied Health Sector Strategy NC was one of 5 states chosen to participate by The National Governors Association Focus on identifying regions and professions in the state facing allied health workforce shortages and encourage industry-led partnerships to address them Intermediate goal: re-envision workforce development system that involves more collaboration between stakeholders Ultimate goals: increase employment, address workforce shortages, raise skill levels, identify and respond to employer needs..improve access to health care?
June 15 th Conference: Please come! The Impact of Health Care and the Allied Health Workforce on North Carolina s Economy Symposium designed to: 1. Discuss relationship between economic development and allied health workforce development efforts underway in NC 2. Describe challenges confronting allied health educators and employers 3. Identify best practices used to meet these challenges Announcement: New grant opportunity to support sector strategies in allied health Time: 8:30-2:30 Location: Friday Center, Chapel Hill Registration: through Greensboro AHEC